Nursing Home Secret Rashes

When an outbreak of scabies is found in any facility that treats and cares for the elderly these outbreaks should be treated more vigorously than a normal outbreak within the general population.

Scabies is caused by a microscopic human mite that consumes human epithelial debris (the top layer of skin) that is eventually shed. The mite lives on the skin and burrows into it, laying its eggs in burrows.


Close contact between elderly people can causes an outbreak as seniors sit in the same chairs and couches as well as have close contact through touch. An infection may take 4-6 weeks to become apparent however due to the incubation period. The scabies rash can be quite itchy and elderly people often have trouble sleeping from other medical conditions. Antihistamines are important to help sleep patterns normalize.

At the first signs of an outbreak of scabies in a nursing home, relatives should be informed and staff alerted. Those suffering from scabies should be isolated from others and their entire bodies treated, including the soles of the feet and beneath the nails. All clothing, fabrics, upholstery etc., should be clean rigorously to destroy the infestation. Benzyl benzoate is commonly used, with a follow up cleaning seven to ten days later.

Staff in nursing homes are at risk of contracting scabies because of the need to have continual and regular contact with patients, including lifting and bathing them. It is essential that staff be treated and be aware of the common signs of scabies, which is often a rash which can occur on different parts of the body. Because it’s contagious, they can lift one patient and transfer to another that they may be walking to the dining room while they hold their hand.

Curiously Norwegian scabies – a more severe form of scabies - occurs often in nursing homes and in patients who are using medications that contain steroids, and those who are suffering from a weakened immune system, senile dementia, leukemia and Down syndrome. Sometimes an oral medication call ivermectin is used for this form of scabies.

With scabies, the signs manifest slowly, and usually begin with itchiness, and in most people a rash shows after a few days of infection. Scabies pictures can look like other problems such as dermatitis or bug bites. It may look like patches of dry skin at first, but with prolonged scratching the rash will spread, usually to wrists, knees and elbows, but can occur in any part of the body. Prolonged scratching can leave the affected open to further bacterial infection.

Several types of lotion are used to treat scabies in a nursing home including permethrin, sulfur or Lindane. For elderly patients suffering from compromised or defective immune systems, an oral medication will be prescribed. The lotion must be applied to the entire body after a bath or shower and must be left on for the entire night. In the morning the lotion should be completely removed by further showering or bathing. Careful observation will then be taken to make sure there is no further infestation, although the skin may itch for two to three weeks post treatment, there may be no scabies mites present. A follow up application approximately one week later should eradicate the scabies mite and their eggs entirely.

Don’t forget that diabetes can manifest as a rash as well and of course it’s important to always look for any wounds or bleeding due to the fact that an elderly person may not feel the impact of something on his skin. Dr. Saunders gives some suggestions below:

If you have diabetes or know someone with it, a natural cure you can read about is here: Diabetes Reveral Guide

how to reverse diabetes

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